Prescription and illegal opioids are commonly abused because they are so addictive. <br /><br />Opioid medications bind to the areas of the brain that control pain and emotions, driving up levels of the feel-good hormone dopamine in the brain's reward areas and producing an intense feeling of euphoria.<br /><br />As the brain becomes used to the feelings, it often takes more and more of the drug to produce the same levels of pain relief and well-being, leading to dependence and, later, addiction.
Prescription and illegal opioids are commonly abused because they are so addictive.

Opioid medications bind to the areas of the brain that control pain and emotions, driving up levels of the feel-good hormone dopamine in the brain's reward areas and producing an intense feeling of euphoria.

As the brain becomes used to the feelings, it often takes more and more of the drug to produce the same levels of pain relief and well-being, leading to dependence and, later, addiction.
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Oxymorphone hydrochloride, under the name Opana ER, was at the center of an HIV outbreak in Indiana in 2015. Some addicts began injecting and shared needles increased the spread of HIV.<br /><br />In June, the Food and Drug Administration requested that Opana ER manufacturer Endo Pharmaceuticals pull the drug from the market. It was the first time the agency has asked that a opioid pain medication be pulled "due to the public health consequences of abuse." Endo announced in July that it would pull the drug.
Oxymorphone hydrochloride —
Oxymorphone hydrochloride, under the name Opana ER, was at the center of an HIV outbreak in Indiana in 2015. Some addicts began injecting and shared needles increased the spread of HIV.

In June, the Food and Drug Administration requested that Opana ER manufacturer Endo Pharmaceuticals pull the drug from the market. It was the first time the agency has asked that a opioid pain medication be pulled "due to the public health consequences of abuse." Endo announced in July that it would pull the drug.
From Opana.com
Codeine is one of the weakest opioids, often given when painkillers such as acetaminophen or ibuprofen fail to work. Because it decreases activity in the part of the brain that controls coughing, it's frequently mixed with other liquids to develop cough syrups for colds and flu. It has frequently been used for pain relief after removal of tonsils and adenoids in children. <br /><br />After an investigation, the FDA restricted the use of codeine and tramadol in children under 12 and recommend against their use in children between 12 and 18 years of age. Additionally, the FDA has warned breastfeeding mothers not to take these medications due to the risk of serious adverse reactions in breastfed infants.
Codeine —
Codeine is one of the weakest opioids, often given when painkillers such as acetaminophen or ibuprofen fail to work. Because it decreases activity in the part of the brain that controls coughing, it's frequently mixed with other liquids to develop cough syrups for colds and flu. It has frequently been used for pain relief after removal of tonsils and adenoids in children.

After an investigation, the FDA restricted the use of codeine and tramadol in children under 12 and recommend against their use in children between 12 and 18 years of age. Additionally, the FDA has warned breastfeeding mothers not to take these medications due to the risk of serious adverse reactions in breastfed infants.
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You can't get heroin by prescription, but many heroin users start off abusing prescription opioids, then turn to this illegal opioid.<br /><br />CNN's Chief Medical Correspondent Dr. Sanjay Gupta <a href="index.php?page=&url=http%3A%2F%2Fwww.cnn.com%2F2014%2F08%2F29%2Fhealth%2Fgupta-unintended-consequences%2F">has reported on recent research </a>that shows today's typical heroin addict starts using at 23, is more likely to live in affluent suburbs and was likely unwittingly led to heroin through painkillers prescribed by his or her doctor.<br /><br /><a href="index.php?page=&url=http%3A%2F%2Fwww.cdc.gov%2Fdrugoverdose%2F" target="_blank" target="_blank">According to the CDC</a>, deaths from overdoses of prescription drugs and heroin continue to be the leading cause of unintentional death for Americans, rising 14% from 2013 to 2014.
Heroin —
You can't get heroin by prescription, but many heroin users start off abusing prescription opioids, then turn to this illegal opioid.

CNN's Chief Medical Correspondent Dr. Sanjay Gupta has reported on recent research that shows today's typical heroin addict starts using at 23, is more likely to live in affluent suburbs and was likely unwittingly led to heroin through painkillers prescribed by his or her doctor.

According to the CDC, deaths from overdoses of prescription drugs and heroin continue to be the leading cause of unintentional death for Americans, rising 14% from 2013 to 2014.
Mukhina Viktoriia/Shutterstock
Fentanyl citrate, pictured here, is a Class II controlled substance and one of the most powerful opioids on the market. It's often administered via injection or transdermal patch, or in lozenge form for pain after surgery, for difficult-to-manage chronic pain and for people who have developed a tolerance to other opioids. <br /><br />The type of fentanyl usually associated with overdoses is bought on the street in powder or pill form and is often mixed with heroin in a clandestine lab to increase the high it produces. Street names include Apache, China girl, goodfella, jackpot, murder 8, TNT and Tango and Cash.
Fentanyl —
Fentanyl citrate, pictured here, is a Class II controlled substance and one of the most powerful opioids on the market. It's often administered via injection or transdermal patch, or in lozenge form for pain after surgery, for difficult-to-manage chronic pain and for people who have developed a tolerance to other opioids.

The type of fentanyl usually associated with overdoses is bought on the street in powder or pill form and is often mixed with heroin in a clandestine lab to increase the high it produces. Street names include Apache, China girl, goodfella, jackpot, murder 8, TNT and Tango and Cash.
Joe Amon/Denver Post/Getty Images
These pills are a more powerful form of codeine, called hydrocodone, and are often mixed with acetaminophen. Hydrocodone is the most frequently prescribed opioid painkiller, <a href="index.php?page=&url=http%3A%2F%2Fwww.dea.gov%2Fdruginfo%2Fdrug_data_sheets%2FHydrocodone.pdf" target="_blank" target="_blank">according to the U.S. Food and Drug Administration</a>, and the most abused. An overdose of hydrocodone can cause "cold and clammy skin, severely constricted pupils, and slow breathing that can lead to a loss of consciousness and death."
Hydrocodone —
These pills are a more powerful form of codeine, called hydrocodone, and are often mixed with acetaminophen. Hydrocodone is the most frequently prescribed opioid painkiller, according to the U.S. Food and Drug Administration, and the most abused. An overdose of hydrocodone can cause "cold and clammy skin, severely constricted pupils, and slow breathing that can lead to a loss of consciousness and death."
Joe Amon/Denver Post/Getty Images
Oxycodone is a powerful narcotic pain reliever prescribed for moderate to high pain relief. It's often given in an extended-release formula for patients who will need to be on pain medications for long periods of time.<br /><br />Patients are warned not to break, chew, crush or dissolve extended-release tablets because the rush of oxycodone into the system could cause serious health problems, including overdose and death.<br /><br />Though highly addictive, oxycodone is not thought to be as frequently abused as hydrocodone. OxyContin, Percocet, Percodan and Tylox are some trade-name oxycodone products.
Oxycodone —
Oxycodone is a powerful narcotic pain reliever prescribed for moderate to high pain relief. It's often given in an extended-release formula for patients who will need to be on pain medications for long periods of time.

Patients are warned not to break, chew, crush or dissolve extended-release tablets because the rush of oxycodone into the system could cause serious health problems, including overdose and death.

Though highly addictive, oxycodone is not thought to be as frequently abused as hydrocodone. OxyContin, Percocet, Percodan and Tylox are some trade-name oxycodone products.
Education Images/UIG/Getty Images
Morphine is another powerful opioid often administered via syringe for severe pain. It can come in pill form, usually as extended-release tablets and capsules, and is prescribed only to relieve difficult, chronic pain that cannot be controlled by the use of other pain medications.<br /><br />As with most opioids, mixing medications, drinking alcohol or taking other meds that contain alcohol, or using street drugs while taking morphine, increases the risk of breathing problems or other serious, life-threatening side effects.
Morphine —
Morphine is another powerful opioid often administered via syringe for severe pain. It can come in pill form, usually as extended-release tablets and capsules, and is prescribed only to relieve difficult, chronic pain that cannot be controlled by the use of other pain medications.

As with most opioids, mixing medications, drinking alcohol or taking other meds that contain alcohol, or using street drugs while taking morphine, increases the risk of breathing problems or other serious, life-threatening side effects.
UniversalImagesGroup/UIG/Getty Images
Meperidine is another narcotic analgesic, similar to morphine. It's often used to help put people to sleep before an operation and to provide pain relief after childbirth. <br /><br />The most common brand name is Demerol, which comes in both tablet and liquid forms. It is usually taken with or without food every three or four hours as needed for pain.<br /><br />As with all opioids, meperidine can cause drowsiness, so never drive a car or operate machinery after taking it until you know how you will react.
Meperidine —
Meperidine is another narcotic analgesic, similar to morphine. It's often used to help put people to sleep before an operation and to provide pain relief after childbirth.

The most common brand name is Demerol, which comes in both tablet and liquid forms. It is usually taken with or without food every three or four hours as needed for pain.

As with all opioids, meperidine can cause drowsiness, so never drive a car or operate machinery after taking it until you know how you will react.
DEA
Hydromorphone is another highly potent prescription painkiller. It's most commonly known by the brand names Dilaudid, pictured here, and Exalgo. <br /><br />Liquid hydromorphone holds the dubious honor of being <a href="index.php?page=&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2730090%2F" target="_blank" target="_blank">frequently mistaken for morphine</a> in hospital "wrong drug" medication errors because of the similarity of the names and appearances. <br />
Hydromorphone —
Hydromorphone is another highly potent prescription painkiller. It's most commonly known by the brand names Dilaudid, pictured here, and Exalgo.

Liquid hydromorphone holds the dubious honor of being frequently mistaken for morphine in hospital "wrong drug" medication errors because of the similarity of the names and appearances.
Joe Amon/Denver Post/Getty Images
Though methadone is used to relieve severe chronic pain, it's most commonly known for preventing withdrawal symptoms in patients who were addicted to opioid drugs, as a part of their recovery process.<br /><br />Methadone has many of the same side effects as other opioids, including weakness, headache, nausea and vomiting, stomach pain, sweating, difficulty urinating, mood changes and vision problems, and difficulty falling asleep or staying asleep.
Methadone —
Though methadone is used to relieve severe chronic pain, it's most commonly known for preventing withdrawal symptoms in patients who were addicted to opioid drugs, as a part of their recovery process.

Methadone has many of the same side effects as other opioids, including weakness, headache, nausea and vomiting, stomach pain, sweating, difficulty urinating, mood changes and vision problems, and difficulty falling asleep or staying asleep.
Whitney Hayward/Press Herald/Getty Images
Buprenorphine is a opioid used as an alternative to methadone to help addicts recovering from heroin use. Buprenorphine is different from other opioids because it's a "partial opioid agonist," which means that when taken in proper prescribed doses, it should produce less euphoria and physical dependence, and therefore a lower potential for misuse. It's also supposed to have a relatively mild withdrawal profile.<br /><br />However, if abused by crushing and snorting or injecting, it can suppress breathing and cause dizziness, confusion, unconsciousness and death.<br /><br />Subutex, the brand name for buprenorphine, is taken as a tablet placed under the tongue and allowed to dissolve.<br /><br />The brand Suboxone is a combination of buprenorphine and naloxone, an opioid antagonist. Antagonists block the opiate receptors in the brain, keeping the narcotic from creating the high abusers crave. <br />
Buprenorphine —
Buprenorphine is a opioid used as an alternative to methadone to help addicts recovering from heroin use. Buprenorphine is different from other opioids because it's a "partial opioid agonist," which means that when taken in proper prescribed doses, it should produce less euphoria and physical dependence, and therefore a lower potential for misuse. It's also supposed to have a relatively mild withdrawal profile.

However, if abused by crushing and snorting or injecting, it can suppress breathing and cause dizziness, confusion, unconsciousness and death.

Subutex, the brand name for buprenorphine, is taken as a tablet placed under the tongue and allowed to dissolve.

The brand Suboxone is a combination of buprenorphine and naloxone, an opioid antagonist. Antagonists block the opiate receptors in the brain, keeping the narcotic from creating the high abusers crave.
Joe Raedle/Getty Images
Opioids: Addictive painkillers

Story highlights

New Jersey has seen a big increase in drug overdose deaths, with 1,600 lives lost in 2015

New Jersey Gov. Chris Christie to chair commission to help fight the opioid epidemic

CNN  — 

New Jersey Gov. Chris Christie will take on an advisory role to help figure out ways the Trump administration can fight the opioid epidemic.

President Donald Trump made the announcement at a meeting at the White House Wednesday, with Christie sitting by his side. Trump introduced him as a “very effective guy” and said the governor will work with representatives in state and local government, as well as law enforcement, medical professionals, and victims to figure out the best ways to deal with this epidemic.

Since 1999, the number of overdose deaths involving opioids quadrupled. From 2000 to 2015, more than 500,000 people died from drug overdoses, and opioids account for the majority of those deaths. It’s estimated 91 Americans die every day from this addiction, according to the Centers for Disease Control and Prevention, and for every death, more than 30 others are admitted to the emergency room.

Photo by Christopher Furlong/Getty Imagesmnedelma
Photo by Christopher Furlong/Getty Imagesmnedelma
Courtesy of Christopher Furlong/Getty Images

Related article 'Deaths of despair' fuel rising midlife mortality for white Americans

The Trump administration has said opioid addiction and treatment are priorities. On the campaign trail, Donald Trump spoke about expanding incentives for states to use drug courts and mandate treatment. He also vowed to expand access to treatment slots.

The proposed Trump budget (PDF) released this month highlighted a $500 million increase from above 2016 levels to expand opioid misuse prevention efforts and to increase drug treatment. It is unclear if that increase would be from additional funds, or if it would be from money made available through the 21st Century Cures Act, which President Barack Obama signed in December. That legislation provides $1 billion for drug treatment for fiscal years 2017 and 2018.

Heroin usage STOCK
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Related article Greatest rise in heroin use was among white people, study says

Christie has spoken at length about his efforts to end the opioid epidemic. His state has had its share of problems. There has been a significant 16.4% increase in drug overdose deaths in New Jersey from 2014 to 2015, according to the CDC. There were 1,600 lives lost in 2015 alone, which is four times the number of homicidesin the state and three times the number of fatalities in accidents that year.

In response, Christie has signed Senate Bill 3, a bipartisan initiative that requires health insurance to cover treatment and substance abuse without delay. “Now, with this legislation, people seeking treatment cannot be denied access in their time of need,” Christie said when signing the bill last month.

NORWICH, CT - MARCH 23: Oxycodone pain pills prescribed for a patient with chronic pain lie on display on March 23, 2016 in Norwich, CT. Communities nationwide are struggling with the unprecidented opioid pain pill and heroin addiction epidemic. On March 15, the U.S. Centers for Disease Control (CDC), announced guidelines for doctors to reduce the amount of opioid painkillers prescribed, in an effort to curb the epidemic. The CDC estimates that most new heroin addicts first became hooked on prescription pain medication before graduating to heroin, which is stronger and cheaper. (Photo by John Moore/Getty Images)
NORWICH, CT - MARCH 23: Oxycodone pain pills prescribed for a patient with chronic pain lie on display on March 23, 2016 in Norwich, CT. Communities nationwide are struggling with the unprecidented opioid pain pill and heroin addiction epidemic. On March 15, the U.S. Centers for Disease Control (CDC), announced guidelines for doctors to reduce the amount of opioid painkillers prescribed, in an effort to curb the epidemic. The CDC estimates that most new heroin addicts first became hooked on prescription pain medication before graduating to heroin, which is stronger and cheaper. (Photo by John Moore/Getty Images)
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Related article Prescriptions may hold clues to who gets hooked on opioids, study says

The law also creates what Christie called some of the country’s strongest maximum limits on initial opioid prescriptions. That means doctors can only give their patients a five-day prescription for opioid pain pills. Other states, including New York, Massachusetts and Maine, have enacted laws that limit prescriptions, but those limits are typically seven days.

These pain pills can become a gateway to addiction and to heroin use, studies show. New Jersey already had a law that requires doctors to consult with a prescription monitoring database before they prescribe opioid painkillers. It’s one of 29 states to make that requirement.

New Jersey has also created commercials featuring the governor telling people where they can go to get help. The state set up a hotline and created a website.

“As I’ve said before addiction is not a moral failing, it is a disease and the more that we talk about it as a disease, treat it as a disease, regulate it as a disease, the more people will finally get the idea that asking for help is not a sign of weakness, but it is in fact a sign of strength,” Christie said at a press conference last month.

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    At a CNN town hall meeting with Health and Human Services Secretary Tom Price this month, addiction recovery specialist and former addict John Brogan credited Christie in part with saving lives in the state. “If it were not for Gov. Christie, there would be 100 more people on top of the 1,600 that we lost last year for this epidemic,” Brogan said.

    Christie met with Trump in February at a White House lunch in which the governor said they spent a “good amount of time” talking about the problem and other ways they could fight the epidemic on a “much broader level.”

    At Wednesday’s White House meeting, Christie said he is honored to take on this task.

    “Every life is an individual life from God and no one life is irredeemable, and people make mistakes we all have, and when people make mistakes of drug use, and it is a mistake, we can’t throw their life away,” Christie said.